Renal DialysisOperated by East Rand Dialysis Inc.

LIFE RENAL DIALYSISFrequently Asked Questions

LIFE RENAL DIALYSIS

WHAT IS KIDNEY OR RENAL FAILURE?

WHY DO KIDNEYS FAIL?

The word renal refers to the kidneys. If one or both kidneys fail completely and the damage cannot be reversed, the condition is called renal failure or end-stage renal disease (ESRD). When this occurs, your kidneys can no longer filter wastes well enough to keep you healthy. Treatments for kidney failure include dialysis and/or transplantation.

Most kidney diseases attack the nephrons (tiny filtering units within the kidneys), causing them to lose their filtering capacity. Damage to the nephrons can happen quickly, often as the result of injury, underlying diseases, or poisoning. However, often the damage will only become apparent after many years.

WHAT ARE THE SIGNS AND SYMPTOMS OF KIDNEY FAILURE?

The following symptoms may be present:

Fatigue (tiredness)

Frequent need to urinate, especially at night (which

grows with time)

Itchy skin Nausea

Shortness of breath

Erectile dysfunction (men have difficulty getting and/or sustaining an erection)

Water retention (swollen feet, hands,

ankles)

Blood and/or protein in the

urine

LIFE RENAL DIALYSIS

CHRONIC KIDNEY DISEASE, ALSO CALLED CHRONIC KIDNEY FAILURE, DESCRIBES THE GRADUAL LOSS OF KIDNEY FUNCTION.

ACUTE KIDNEY FAILURE OCCURS WHEN YOUR KIDNEYS SUDDENLY BECOME UNABLE TO FILTER WASTE PRODUCTS FROM YOUR BLOOD.

WHAT ARE MY TREATMENT OPTIONS?

WHAT IS THE DIFFERENCE BETWEEN CHRONIC AND ACUTE KIDNEY FAILURE?

• When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood’s chemical makeup may get out of balance.

• Acute kidney failure can be fatal and requires intensive treatment. However, acute kidney failure may be reversible. If you’re otherwise in good health, you may recover normal or nearly normal kidney function.

When the kidneys are no longer working effectively, waste products and fluid build up in the blood.

1. Dialysis treatments may be used for patients who have become ill and have acute renal failure (temporary loss of kidney function), or for fairly stable patients who have permanently lost kidney function (stage 5 chronic kidney disease).

2. Kidney transplantation

Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine.

• When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

• Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

KIDNEY FAILURE SYMPTOMS

LIFE RENAL DIALYSIS

THERE ARE TWO MAJOR TYPES OF DIALYSIS

Haemodialysis

Peritoneal dialysis

A medical procedure to remove excess fluid and waste products from the blood and to correct electrolyte imbalances. This is accomplished using a machine and a dialyser, also referred to as an artificial kidney.

Use the lining of your abdominal cavity (the space in your body that holds organs like the stomach, intestines, and liver) to filter your blood. This kind of dialysis is needed daily hence the name of this treatment – continuous ambulatory peritoneal dialysis and criteria needs to be closely discussed together with your doctor.

Connector

SolutionBag

DrainageBag

Connector

Catheter

Venous Pressure Monitor

DIALYSER

Membranes

Air Trap

BloodPump

HeparinInfusion

ArterialPressureMonitor

Clean blood returned to

the body

Blood Removed For

Cleansing

Fresh Dialysing Solution

Used Dialysing Solution

Appointment with a nephrologist for a dialysis prescription

HOW DOES DIALYSIS WORK?Blood travels through dialysis blood lines to the dialyser, also known as the artificial kidney. The dialyser is made up of two compartments, blood and dialysate. Porous membranes inside the dialyser allow for the movement of waste products, electrolytes and water between compartments through a process of osmosis and diffusion. These exchanges continue over the prescribed dialysis session until a balance of electrolytes and effective removal of waste products is achieved.

WHERE DO WE GO FROM HERE?Life Healthcare case managers will assist and guide you with the following process:

■ Obtaining relevant medical aid forms ■ Ensuring completion of the forms by your treating specialist ■ Returning the forms and your latest blood test results to the medical aid ■ Obtaining an additional motivation by your nephrologist in the case of some specialised

procedures such as continuous renal replacement therapy (CRRT)

If you have a medical aid: Renal dialysis patients covered by a medical scheme should note that whilst every effort is made to obtain payment from your medical scheme on your behalf, the responsibility for the payment of services rendered still remains with the guarantor. Any costs not covered by your medical scheme will have to be settled by the patient receiving treatment or medical aid guarantor. If you are unsure of any financial matter, please speak to one of our case managers at the hospital you are receiving treatment at. Please note that services provided by other medical practitioners and healthcare professionals are not included in the account for dialysis treatments and will be charged separately.

Please note that you will need a separate authorisation number for dialysis treatment; a hospital authorisation number will not provide authorisation.

LIFE RENAL DIALYSIS

WHAT ARRANGEMENTS DO I NEED TO MAKE TO RECEIVE CHRONIC DIALYSIS?

Doctor consultation

Medication script from my treating

doctor

Medical aid approval or

private funding

Dialysis time slot

LIFE RENAL DIALYSIS

It is very important that you follow the unit’s strict hand washing and infection control programme. This will ensure the health of yourself, your families and other fellow dialysis patients.

Any unusual redness or pain around your vascular access site must be noted together with your dialysis nurse.

What about infection control?3

As kidney function declines, protein waste and minerals become more difficult for the kidney to remove. The main nutrients limited in kidney diets include protein, phosphorus, potassium and sodium.

Not only will a good diet help you feel healthy, it can also help you avoid complications such as fluid overload, high blood potassium, bone disease, and weight loss. Keeping close track of your diet can also help you control other diseases such as diabetes and high blood pressure. Uncontrolled blood pressure and diabetes can worsen kidney disease and diminish any residual kidney function.

Is a renal diet important whilst undergoing dialysis treatments?2

FREQUENTLY ASKED QUESTIONS

Treatment selection will be discussed during consultation together with your Nephrologist. The option selected will be in your best interest and considerations to working hours, travel and lifestyle will be considered. Very specific criteria for selection of either treatment needs to be considered and your Nephrologist will support you through this treatment selection.

How do I choose between haemodialysis and peritoneal dialysis?1

If you are paying privately:Patients who are not covered by a medical scheme will be required to pay a deposit based on the estimated total costs of treatments delivered.

Please note that services provided by other medical practitioners and healthcare professionals are not included in the account for dialysis treatments and will be charged separately.

WHERE DO WE GO FROM HERE? continued

FREQUENTLY ASKED QUESTIONS continued

These vary between the different facilities’ operating times and available sessions. An appropriate session that suits both the renal facility and yourself will be discussed prior to your first dialysis session. Your frequency of treatments and duration of each session will be determined by your facility nephrologist or physician pending individual clinical status and kidney function.

For purposes of understanding how dialysis sessions work, the most common treatment programme to achieve adequate clearance are four hour sessions, three times a week. You will be required to select one slot that comprises 2-3 sessions per week.

For your convenience selected facilities do provide evening sessions. This will have to be discussed with your facility unit manager and will depend on the availability of evening slots.

What are the treatment times for chronic haemodialysis?5

LIFE RENAL DIALYSIS

For example morning (am) sessions may run:

Slot 1 - 06:00-10:00 on a Monday, Wednesday and Friday or

Slot 2 - 06:00-10:00 on a Tuesday, Thursday and Saturday

For example afternoon (pm) sessions may run:

Slot 3 - 11:00-14:00 on a Monday, Wednesday and Friday or

Slot 4 - 11:00-14:00 on a Tuesday, Thursday and Saturday

Chronic patients required to take any medication before, during or after dialysis will be required to bring their own medication from home. Please inform your dialysis nurse of such instances so as to ensure that treatment is administered appropriately, recorded and supervised.

For convenience, medication such as erythropoietin (EPO) and iron, can be stored and refrigerated at your dialysis facility. Please confirm the process used for receiving and storing of EPO with the unit managers. The cold chain should be maintained even during transportation between your home and the dialysis facility. It is important that medication needing refrigeration is kept at the recommended temperature. This is referred to as the cold chain.

What about my medication?4

LIFE RENAL DIALYSIS

FREQUENTLY ASKED QUESTIONS continued

■ Equipment – latest technology dialysis machines and comfortable dialysis chairs ■ Medical services – easy access to hospital specialist / physicians / radiology

department / laboratory facilities ■ Public phones – facility telephones are not available for personal use. If there is

any emergency, the nursing staff will contact your family ■ Smoking – all facilities are strictly non-smoking facilities and as such, smoking is

only allowed in designated smoking areas

Tell me more about your facilities and services8

Your feedback with regard to our facilities and services are important to us. Please share your suggestions, concerns, compliments or complaints with us. Our managers will also make regular rounds. As your comfort and care are important to us, we encourage you to speak freely with them

How do you monitor service delivery?9

Kidney transplantation is a process that requires clinical and pathology work-up. There are strict criteria measures that need to be met prior to transplantation. Please engage together with your Nephrologist to discuss options best suited for you. Options will vary between patients pending individual clinical status

How long will it take to receive a kidney transplant?10

Visitors are discouraged from entering treatment areas for maintenance of strict infection control measures. Visitors are encouraged to make use of waiting rooms

May I have visitors?6

We recommend that you do not bring valuables such as jewellery, or large sums of money with you. Dialysis facilities are not equipped with safes and whilst every effort is made to protect patient’s belongings, we cannot take responsibility for your belonging or the loss thereof

What will happen to my valuables?7

LIFE RENAL DIALYSIS

Contact detailsEASTERN CAPE LIFE EAST LONDON PRIVATE HOSPITAL32 Albany Street, East London, 5201 Telephone number: 043 722 3128Fax number: 043 722 3575

LIFE MERCANTILE HOSPITALCnr Kempston & Durban Roads, Korsten, Port Elizabeth, 6020Telephone number: 041 404 0400Fax number: 041 404 0551

FREE STATELIFE ROSEPARK HOSPITAL57 Gustav Crescent, Fichardt Park, Bloemfontein, 9301Telephone number: 051 505 5111Fax number: 051 522 6769 or 0977

GAUTENGLIFE BEDFORD GARDENS HOSPITAL7 Leicester Road, Bedford Gardens, Bedfordview, 2008 Telephone number: 011 677 8500Fax number: 011 616 2760

LIFE BRENTHURST HOSPITAL4 Park Lane, Parktown, Johannesburg, 2193Telephone number: 011 647 9000Fax number: 011 647 9009

LIFE CARSTENHOF HOSPITAL21 Dane Road, Glen Austin, Midrand 1685Telephone number: 011 655 5500Fax number: 011 310 2318

LIFE FOURWAYS HOSPITALCnr Cedar Road & Cedar Avenue West, Fourways, 2055 Telephone number: 011 875 1000Fax number: 011 875 1001

LIFE GROENKLOOF HOSPITAL50 George Storrar Drive, Groenkloof, Pretoria 0181Telephone number: 012 424 3600Fax number: 012 346 0562

LIFE ROBINSON PRIVATE HOSPITALHospital Road, Randfontein, 1759Telephone number: 011 278 8700Fax number: 011 693 3109

LIFE SPRINGS PARKLAND HOSPITALSprings West Road, Pollak Park, Springs, 1559Telephone number: 011 812 4000Fax number: 011 812 4100

LIFE THE GLYNNWOOD 33-35 Harrison Street, Benoni, 1501 Telephone number: 011 741 5000Fax number: 011 421 1242

LIFE WILGEHEUWEL HOSPITALAmplifier Road, Radiokop Ext 13, Roodepoort, 1724Telephone number: 011 796 6500Fax number: 086 500 9213

KWAZULU-NATALLIFE CHATSMED GARDEN HOSPITAL80 Woodhurst Drive, Woodhurst, Chatsworth, 4092Telephone number: 031 459 8000Fax number: 031 403 5388

LIFE EMPANGENI PRIVATE HOSPITALCnr Biyela & Ukula Streets, Empangeni, 3880Telephone number: 035 902 8000Fax number: 035 772 2038

LIFE ENTABENI HOSPITAL148 Mazisi Kunene (South Ridge) Road, Berea, Durban, 4001Telephone number: 031 204 1300Fax number: 031 261 6435

LIFE HILTON PRIVATE HOSPITALCnr Hilton Avenue & Monzali Drive, HiltonTelephone number: 033 329 5600Fax number: 033 329 5601

LIFE MOUNT EDGECOMBE HOSPITAL163 – 179 Redberry Road, Rockford, Phoenix, 4068Telephone number: 031 537 4000Fax number: 031 502 1207

LIFE WESTVILLE HOSPITAL7 Spine Road, Westville, 3630Telephone number: 031 251 6911Fax number: 031 265 0952

MPUMALANGALIFE COSMOS HOSPITALCnr OR Tambo & Beatty Avenue, eMalahleni, Mpumalanga, 1035Telephone number: 013 653 8000Fax number: 013 653 8005

LIFE MIDMED HOSPITALCnr OR Tambo & Joubert Streets, Middelburg, Mpumalanga, 1055Telephone number: 013 283 8700Fax number: 013 282 6126

NORTH WESTLIFE ANNCRON HOSPITAL:Klerksdorp16 Van Rynefeld Street, Willkoppies, Klerksdorp, 2571Telephone number: 018 464 1337

Viljoenskroon20 Engelbrecht Street, Viljoenskroon, 9520

Hartswater4 Eric Louw Street, Hartswater, 8570 LichtenburgShop no 2 Spar Komplex, Beyers Naudé Street, Burgersdorp, 2740

LIFE PEGLERAE HOSPITALCnr Heysteck and Church StreetTelephone number: 014 594 9517Fax number: 014 594 9518

WESTERN CAPELIFE KNYSNA PRIVATE HOSPITALHunters Estate Drive, Hunters Home, Knysna, 6570Telephone number: 044 384 1083Fax number: 086 678 9178

LIFE VINCENT PALLOTTI HOSPITAL Alexandra Road, Pinelands, Cape Town, 7405Telephone number: 021 506 5111 Fax number: 021 531 0116

BOTSWANALIFE GABORONE PRIVATE HOSPITALPlot 8448, Segoditshane Road, Mica Way, Broadhurst, GaboroneTelephone number: 00267 368 5600Fax number: 00267 390 1998

National spread of chronic renal units and mobile renal units